Liu Song, He Jian, Guan Wenxian, Li Qiang, Zhang Xiaoqi, Mao Hui, Yu Haiping, Zhou Zhengyang
From the *Departments of Radiology, †Gastrointestinal Surgery, and ‡Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China; and §Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
J Comput Assist Tomogr. 2014 Jul-Aug;38(4):544-50. doi: 10.1097/RCT.0000000000000090.
The objective of our study was to assess the clinical feasibility of diffusion-weighted (DW) magnetic resonance (MR) imaging in preoperative T staging of gastric cancer prospectively.
Forty-five patients underwent axial T2-weighted (T2W) and DW (b, 0 and 1000 seconds/mm) MR imaging. Two radiologists interpreted the images for detection and staging of the tumors independently. The McNemar test was used to check differences in diagnostic accuracy with the reference of postoperative histopathological results.
Diffusion-weighted and T2W images detected 44 and 42 of 45 histologically confirmed lesions, respectively. Furthermore, DW images detected 11 of 12 pT1 lesions compared to 9 of 12 lesions by T2W images. The staging accuracy of advanced gastric cancer (≥pT2) in DW imaging is significantly higher than that in T2W imaging (87.9% and 69.7%, respectively; P < 0.05).
Diffusion-weighted is superior to T2W imaging in detection of early gastric cancers (pT1) and staging advanced cancers (≥pT2).
本研究的目的是前瞻性评估扩散加权磁共振成像在胃癌术前T分期中的临床可行性。
45例患者接受了轴位T2加权（T2W）和扩散加权（b值为0和1000秒/平方毫米）磁共振成像检查。两名放射科医生独立解读图像以检测肿瘤并进行分期。采用McNemar检验，以术后组织病理学结果为参照检查诊断准确性的差异。
扩散加权成像和T2W成像分别检测出45个经组织学证实病变中的44个和42个。此外，扩散加权成像检测出12个pT1病变中的11个，而T2W成像检测出12个病变中的9个。扩散加权成像对进展期胃癌（≥pT2）的分期准确性显著高于T2W成像（分别为87.9%和69.7%；P<0.05）。
在早期胃癌（pT1）的检测和进展期癌（≥pT2）的分期方面，扩散加权成像优于T2W成像。
